| NPI | 1972987485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NE 1580) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT002888) |
| 152W00000X Optometrist (Licence: CO OPT0003367) | |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2022-11-09 |